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高用量スタチン療法と中量用量スタチン療法との比較で,インシデント糖尿病のリスク:メタ解析
David Preiss1, Sreenivasa Rao Kondapally Seshasai, Paul Welsh
1BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Pl, Glasgow G12 8TA, Scotland, United Kingdom. david.preiss@glasgow.ac.uk
JAMA
|June 23, 2011
まとめ
高用量スタチンの治療は,中程度の用量治療と比較して,新規発症の糖尿病を発症するリスクを12%増加させます. しかし,心血管疾患の発生率も16%減少させています.
科学分野:
- 心臓病学 心臓病学
- メタボリック障害 メタボリック障害
- クリニック・トライアル 臨床試験
背景:
- スタチンの治療は,糖尿病のリスクの増加と関連しています.
- 以前のメタアナリシスは,スタチンと糖尿病の発症との潜在的な関連性を示しています.
研究 の 目的:
- スタチンの集中投与量と中等投与量による糖尿病新発症のリスクを比較する.
- 高用量スタチン療法と中等用量療法の心血管上の効果を評価する.
主な方法:
- 5つのランダム化比較試験のメタアナリシスが行われました.
- 含めた試験は,1000人以上の参加者を対象に,1年以上にわたって追跡した,濃縮用量対中量投与スタチン治療を比較した.
- 新たに発症した糖尿病および主要な心血管疾患に関するデータは,ランダム効果モデルを使用して抽出および分析されました.
主要な成果:
- 高用量スタチンの治療は,新規発症糖尿病のリスクが12%増加した (OR1.12;95%CI,1.04-1.22) と関連していました.
- 新たに発症した糖尿病に害を与えるのに必要な数は,年間498人でした.
- 高用量スタチンの治療は,主要心血管疾患の16%の減少を示した (OR 0.84;95%CI,0.75-0.94).
- 心血管疾患の治療に必要な患者数は,年間155人でした.
結論:
- 高用量スタチンの治療は,中等用量治療と比較して,新規発症糖尿病のリスクが高いと関連しています.
- 糖尿病のリスクが増加したにもかかわらず,高用量スタチンは心臓血管に重大な利点をもたらします.
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